The challenge
The US needed a website for millions to compare and buy health insurance.
The case
HealthCare.gov, the federal marketplace created by the Affordable Care Act, launched on October 1, 2013, and failed almost immediately: pages crashed, and only a handful of people managed to enroll on the first day. Contracts had been split across many vendors with no one fully in charge, and the system was not tested end to end. A rescue team of engineers stabilized it within about two months. In the first enrollment period, more than 5.4 million people selected a plan through the federal marketplace, out of over 8 million across all marketplaces. The crisis led to the creation of the US Digital Service.
Why the results were mixed
Big-bang launches without a single accountable owner and real testing are high risk. The recovery showed what small, empowered technical teams can do, and changed how the US government builds technology.
Sources
- US Department of Health and Human Services, Office of Inspector General (2016). HealthCare.gov: Case study of CMS management of the federal marketplace.
- ASPE (2014). Health Insurance Marketplace: Summary enrollment report for the initial annual open enrollment period.
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